Individual provider Active NPI

Maureen Judith Kimmeth, O.D.

  • Optometrist
  • Washington, DC
National Provider Identifier
1619009693
Registry record updated Jan 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1000016 Issued in DC
Practice address
801 Pennsylvania Ave NW
Ste 4a
Washington, DC 20004-2615
Phone
(202) 783-5318
Fax
(202) 783-5319
NPI assigned
Mar 12, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 18, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1000016 DC Primary

Addresses

Primary practice location

801 Pennsylvania Ave NW
Ste 4a
Washington, DC 20004-2615

Mailing address

701 Pennsylvania Ave NW
Washington, DC 20004-2608
Phone (202) 783-5318

Other identifiers 1

IdentifierTypeStateIssuer
0019MedicaidDC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140204001422 DC Practitioner - Optometry 0547499097 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

801 Pennsylvania Ave NW
Washington, DC 20004-2615

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1000016DCMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
M&Mak Inc Optometrist Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1173657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547769600000",
    "number": "1619009693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 PENNSYLVANIA AVE NW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200042608",
            "telephone_number": "202-783-5318",
            "fax_number": "202-783-5319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 PENNSYLVANIA AVE NW",
            "address_2": "STE 4A",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200042615",
            "telephone_number": "202-783-5318",
            "fax_number": "202-783-5319"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIMMETH",
        "first_name": "MAUREEN",
        "middle_name": "JUDITH",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-12",
        "last_updated": "2019-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "DC",
            "license": "1000016",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0019",
            "state": "DC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

Verify at the official NPI Registry.